Gastroenterology & Hepatology — Flashcards

Flashcard 551: What is the management of life-threatening C. diff? _____ & Oral vancomycin AND IV metronidazole

Answer: Stop current ABX if possible

Flashcard 552: _____ may be considered in patients who have had at least two recurrences of C.diff infection (i.e. 3rd episode or more)

Answer: Faecal transplant

Flashcard 553: C. diff stool antigen testing shows _____

Answer: exposure to C. diff

Flashcard 554: Aside from antibiotics, what other medication increases risk of C. diff? _____

Answer: PPIs

Flashcard 555: Life threatening C. diff infections are indicated by findings such as: _____, ileus, toxic megacolon

Answer: hypotension

Flashcard 556: C. diff bacteria produce an _____ which damages the intestines and can cause pseudomembranous colitis

Answer: exotoxin

Flashcard 557: Blood tests will often show _____ in C. diff infection

Answer: raised WCC

Flashcard 558: What is the management of first episode *C. difficile* infection? _____ & Oral Vancomycin (or Fidaxomicin) for 10 days

Answer: Stop inciting antibiotics

Extra: According to current IDSA/SHEA guidelines, both **Oral Vancomycin** (125 mg QID) and **Fidaxomicin** are preferred over Metronidazole for the first episode of C. diff, regardless of severity (non-severe vs. severe). Metronidazole is now only used if the others are unavailable.

Flashcard 559: _____ diagnosis should be considered if the patient has the following for ≥ 6 months: Abdominal pain and/or Bloating and/or Change in bowel habit

Answer: Irritable Bowel Syndrome

Flashcard 560: What is the first-line investigation for hiatus hernia?

Answer:

Extra: Barium swallow is traditionally the first-line investigation for diagnosing a hiatus hernia as it clearly outlines the anatomy of the gastroesophageal junction. Endoscopy is also frequently performed but is less sensitive for small hernias.